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General NPI Number Information
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NPI Number | 1033622162
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Entity Type | Individual
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Provider Name | SUZANNA M LUERAS
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Gender | Female
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Dates
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Enumeration Date | 11/11/2017
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Last Update Date | 03/30/2022
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Provider Practice Location Address
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Address Line | 4425 JUAN TABO BLVD NE STE 220
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-2681
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Country | US
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Telephone | 505-418-1755
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Fax |
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Provider Business Mailing Address
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Address Line | 6300 RIVERSIDE PLAZA LN NW STE 100
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-1908
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Country | US
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Telephone | 505-418-1755
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 0188361
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CCMH0207301
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 0188361
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License Number State | NM
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Taxonomy #4
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | CCMH0207301
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License Number State | NM
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